With drug overdose deaths on rise, experts push to recognize signs of addiction

Prescription medicine / iStockphoto

Drug addiction can be a hard fact to face and accept, but it's an ongoing problem that needs dire attention.

A new report published in Tuesday's Journal of the American Medical Association shows that drug overdose deaths were on the rise for the 11th straight year. There were a total of 38,329 drug overdose deaths in 2010 according to the Centers of Disease Control and Prevention -- and 60 percent were due to medications, the majority of which were prescription drugs.

• Drug overdose deaths up for 11th consecutive year

Opiod drugs, which include OxyContin and Vicodin, were the most frequently involved, accounting for three out of four medication overdose deaths. Only 17 percent of the deaths were suicides, meaning the vast majority were unintentional overdoses.

"The big picture is that this is a big problem that has gotten much worse quickly," Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, told the Associated Press.

The first step though is recognizing or helping others recognize that they need help. Some signs that a loved one or a friend might need help include seeing behavioral changes that seem out of the ordinary.

Family members may notice a person's mood swings, altered sleep habits, bizarre behavior including lying and stealing, changes in friends or social groups and unexpected weight loss, Dr. Greg Johnson, a staff physician at Origins Recovery Centers in South Padre Island, Texas, said to CBSNews.com.

For co-workers, this could mean noticing they are becoming less reliable, coming later to work, missing deadlines, isolating themselves in their offices and having more unexcused absences or more absences attributed to illness, Dr. David Sack, CEO of Promises Treatment Centers, told CBSNews.com. They may also have more financial problems like borrowing against their 401Ks or taking money out of their savings. Frequent medical visits for panic attacks or chest palpitations can also be a sign.

Both experts have noticed that younger addicts are seeking treatment -- and believe prescription drugs may be to blame. More adults are on prescription drugs, giving a larger population of children access to them, Johnson pointed out. While alcohol and marijuana still remain "gateway" drugs, he said, young people have easier access to prescription pills from their parent's cabinets. Some start while they are just in middle school.

"A parent may notice at the end of the month, but they may or may not get the idea that their kid is stealing from them," Johnson said.

Sack believes that prescription drug abuse has increased recently because doctors have been prescribing them more freely. While 40 years ago, many physicians held off from giving out pain medication, in the 1970s many medical professionals saw how these pills could help treat pain in people like cancer patients.

"There was a push for a better job of treating all forms of chronic pain," Sack said. "It was a very big initiative around the U.S. and the world."

Frieden added to AP that many doctors and patients don't realize how addictive prescription painkillers can be. He believes they are often given for conditions that could have been managed with less addictive drugs.

Five signs a loved one is abusing painkillers

But what people may not realize is that opioids are the same class of drugs as heroin, only in prescription form. The doctors say that they both are seeing more and more people turning to heroin use. Sack believes part of the reason is that after a while opioid drugs can become expensive, and black tar heroin is much cheaper. At that point, many addicts are what Johnson likes to call "polysubstance abusers."

"They'll do Xanax and 'xanibars' if they are here and available, and cocaine if they can get their hands on it, and they'll do heroin if there's heroin," Johnson said.

Sack believes that part of what makes prescription drugs seem safe is that they come from pharmacies and doctors. But, since many prescription narcotics are respiratory depressants, and many people who abuse them use them in conjunction with other depressants like alcohol or sedative hypnotics like Xanax or Ambien, it can lead to negative consequences -- possibly death, Sack said. Johnson has heard of Vicodin, Soma and Xanax referred to as the "Holy Trinity," meaning that drug addicts like to use all three at the same time.

"It's kind of the Heath Ledger phenomenon," Sack explained. "Even though any one of them are not enough to cause an overdose, two or three of theme together is enough."

There are many ways to treat addiction, but all of them come with their risks and benefits. Promises Treatment Centers uses a multifaceted approach of detox, traditional medicine and complimentary treatment like yoga, meditation or acupuncture, and emphasizes community support. For Origins Recovery Centers, they try to aid in drug addiction recovery with a 12-step program and use a mixture of psychiatric, physical and clinical care lasting at least 90 days, with a 24-month follow up period.

"We believe in the concept of if you're treating a disease like you are treating diabetes, you need to have some ongoing care," Johnson explained about Origins' approach. "If you are a diabetic, you wouldn't go to the doctor and be treated for 30 days and then be sent home."

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There's also additional medications that can help a patient wean themselves off an addiction. One method uses Naltrexone, which blocks opioid receptors and stops people from getting high. It can also decrease cravings.

A problem with Naltrexone is that it comes in a daily pill, and sometimes that can be a challenge for addicts to continue with the regiment. Missing a few doses decreases the effectiveness, Sack pointed out. Another version of Naltrexone called Vivitrol only involves a once a month shot, but it can be quite costly, Johnson added. Whereas Sack believes that medications like Naltrexone can be beneficial for people who've had even short term addictions and help them beat them, Johnson thinks that putting addicts on another substance should only be reserved for people who have relapsed many times.

Another form of therapy called medication-assisted or opiate-assisted therapy (also known as maintenance therapy) replaces the drug of choice with other medications like methadone. Since methadone has a longer half-life, people don't experience the euphoria with use like they do when they abuse other drugs like heroin. Still, it can make people addicted to this new substance, so Sack only recommends it for people who repeatedly relapse.

But, the most important part of recovery is recognizing there is a problem.

"The first step is an addict has to hit some type of a bottom or find something that convinces them that they are powerless, that I can no longer do heroin so I have to find another way," Johnson stated.

[cleansemart]

Withdrawing from marijuana dependency, however, will be a physically challenging process, because the residues from marijuana will remain in your system much longer than those of many other drugs. The toxins left behind by marijuana usage will collect in your fatty tissues, where t hey can be difficult to flush out. You can have traces of THC, the ingredient responsible for the marijuana high, remaining in your system for as long as a month after you have last used the drug.
www.cleansemart.com/detox/cleansing-for-a-drug-test-detox-marijuana-cleansing-after-drug-use.html
Why You use Marijuana Detox Drinks
The difficulty in removing all traces of marijuana during withdrawal is one reason why marijuana detox should be performed in a drug rehab center. You may need medical assistance and transition medications to help you manage your cravings for weed once you have begun the withdrawal phase of your treatment. For that, you'll need medical specialists experienced inhaling the marijuana detox process.

[infinity8child]

My first continuing experience with the apsence in power in my life begins with the inability to control sleep. That leads to seekeing a need to controll other things that I think I can control (ie mood, energy, sexual desire and ability)

[NeuroscienceAddict]

Addiction is a chronic, progressive brain disease. It's treatable. Perhaps not as successfully as one might like, but on a par with other chronic diseases that require substantial behavioral change, like diabetes and hypertension.

Unfortunately, many people still don't believe addiction is a disease. That's why science-based education is so important.

For a not-for-profit website that discusses the science of substance use and abuse in accessible English (how alcohol and drugs work in the brain; how addiction develops; why addiction is a chronic, progressive brain disease; what parts of the brain malfunction as a result of substance abuse; how that malfunction skews decision-making and motivation, resulting in addict behaviors; why some get addicted while others don't; how treatment works; how well treatment works; why relapse is common; what family and friends can do; etc.) please click on www.AddictScience.com.

[judderwocky]

@RocketToTheStars

By your own logic wouldn't the gene pool benefit by you being removed from it? If you are going to level that judgement against someone else, you had better be willing to cast the same lens on yourself. Who is the weak one. Just how how bad is your supposedly "severe" pain.

I'll be honest. I think anybody that uses chronic pain meds are "weak". I hate my toe cut off with a lawnmower. They gave me pain meds for a few days in the hospital, I didn't use them when I got out. At all.

[DrJohnWarren]

If I might add a touch of reality to the theory. There is so much talk about the "poor drug addicted people who seemingly can't read a dosage label". Might we look at how the present laws affect the ordinary, non-criminal who has chronic pain?

For the last ten years, I've suffered from what the doctors call idiopathic neuropathy. In simple terms, I hurt, and they don't know why. We've tried a multitude of treatments, but only one thing is clear, regular doses of Oxycodone, an opiate derivative, a Schedule II narcotic, reduces the pain to manageability. (It could probably eliminate it, but that would mean a high enough dose so that my body would respond by creating more neural pass ways which would demand a greater dose... in a continuing upward spiral. As it is, I'm managed to keep the dose relatively constant.)

That's one fact.

Here's another. I'm a pretty average citizen. I have no criminal record beyond a single speeding ticket. I vote regularly. I'm the kind of guy that you'd think could be pretty much left alone to manage his life.

You're probably pretty used to being able to shop where you want. Well, I can't. Despite a massively expensive prescription drug tracking system the government added, I can only buy my Oxycodone at a single drug store... and if they are out of it, I have to wait. I can't just go down the street and try another place.

When you get a prescription, you might get one that's good for three months with a couple of renewals thrown in. Not so here. Each prescription is good for one month and no renewals.

When the renewals run out, you notify your doctor or your pharmacist notifies him or her and it's faxed or emailed to the store. Not so here. I have to drive to my doctor's office, get a written prescription, bring it to the one pharmacy that I'm allowed to use and wait for it to be filled.

Added to this, I have to have regular urine tests to make sure I'm really taking the drugs.

It gets better. I'm lucky I that today have a good doctor who is willing to jump through the hoops because she recognizes that the drug is an important part of my health plan. However, she's asked me not to tell anyone who she is. You see, doctors are scared now. They're scared because the police (http://articles.sun-sentinel.com/2012-02-12/news/fl-pain-pills-mayocol-b021212-20120211_1_pain-clinic-pain-prescriptions-pain-patients) are targeting the ones who prescribe "too many" pills, but won't even reveal what that threshold is. Even a Walgreens distribution center was given a cease-and-desist order without any evidence of wrongdoing. (http://articles.orlandosentinel.com/2012-10-11/news/os-walgreens-dea-oxycodone-20121011_1_walgreens-pharmacy-distribution-center-dea) She's scared that too many people in pain will come to her office, and if she takes care of them, she could be arrested.

How about thinking of US for a minute.

[RocketToTheStars]

I have been taking Vicodin for about 8 years for pain. I can feel myself getting addicted then I stop taking it for four or five days in order to "re-set" my addiction "clock." Sure, I feel like crap for the next 36 hours but I do not want to have a long-term addiction but I do want to manage the severe pain I suffer from. Regarding people who take overdoses due to "experimenting" with drugs, I say there is no loss to society, but actually a benefit since we are losing the "weak" from the gene pool and reducing the overall population of the earth (a very worthwhile goal.)

[irishfly]

What a callous comment. I hope you haven't reproduced, or won't, as clearly you lack empathy, and are, indeed, the "weak" of which you speak.

[500cubic]

Marlahooch1-- I looked to see what you were reacting to --Marijuana -gateway drug- Not mentioned --Except by you--?

[MarlaHooch1]

This makes me so mad.

MARIJUANA IS NOT A GATEWAY DRUG!!!

Why is this even mentioned? This article is supposed to be about an epidemic costing people's lives and devastating families across the country.

You know who tries cocaine? DRUNK PEOPLE. Let's ban alcohol, it leads to other drugs and it kills people!

I'm sick of the propaganda nonsense holding back actual progress in this country.

Help yourself to a freaking science book, CBS!

[DKlos]

Pot is a gateway drug. Pot is also very bad for people under age 25. Do some research of your own.

[MarlaHooch1]

This

[tiberias77]

My old doctor warned me re the direction the DEA and MD's watchdogs shortly before he died in 2006. How right he was. Today we have the Doctor O'z syndrome of shuck and jive. I am 63 years old and suffered with chronic pain for over 30 years. Today regardless of MRI verification of legit disorders the powers that be send you to "rehab" for everything. Pain meds? Are you kidding! There is no use crying about it the dye is cast. As long as you dance to their tune....all money oriented...see them every three months,endure two hours in the waiting room...you won't get your meds. I am not talking the "hard" stuff like percocette, vicodin, opiates in general. You need a "special" pain med specialist to even consider prescribing them. Watch for the next phase by watching Dr O'z travelling wagon or The Doctors...a TV show with a cast of MD's! Whatever they say is "dangerous" will soon be outlawed...I.E. sleeping meds and the like. I am too old for this s**t and thank God I was able to stop over 30 years of dependence on pain meds with relative ease. Guys I hope before I die this will come full circle. Its not about addiction concerns. Its about $$$. My prediction...non-criminals will become criminals because nobody hears them re pain.